Prophylactic antibiotics and the hospital budget: controversy for patients and hospital financial strategies?

Although total drug costs account for only 2 to 3% of the total hospital budget, the management of these costs is of much interest. Total costs can be subdivided into numerous items; each can be influenced to some extent. Such costs are analysed in this article. The Dutch system of hospital budgeting is also described. The way in which (prophylactic) antibiotics can influence budget parameters is described and quantified by an example in gynaecological surgery. It is concluded that the profits of modern pharmacotherapy in the hospitals are earned outside the hospital. Society should realize that these profits must be re-invested to assure a healthy health-care system in the near future.